title: Reform of how health care is paid for in China: challenges and opportunities.
abstract: China's current strategy to improve how health services are paid for is headed in the right direction, but much more remains to be done. The problems to be resolved, reflecting the setbacks of recent decades, are substantial: high levels of out-of-pocket payments and cost escalation, stalled progress in providing adequate health insurance for all, widespread inefficiencies in health facilities, uneven quality, extensive inequality, and perverse incentives for hospitals and doctors. China's leadership is taking bold steps to accelerate improvement, including increasing government spending on health and committing to reaching 100% insurance coverage by 2010. China's efforts are part of a worldwide transformation in the financing of health care that will dominate global health in the 21st century. The prospects that China will complete this transformation successfully in the next two decades are good, although success is not guaranteed. The real test, as other countries have experienced, will come when tougher reforms have to be introduced.
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Shanlian
authors.initials: S
authors.lastname: Hu
authors.forename: Shenglan
authors.initials: S
authors.lastname: Tang
authors.forename: Yuanli
authors.initials: Y
authors.lastname: Liu
authors.forename: Yuxin
authors.initials: Y
authors.lastname: Zhao
authors.forename: Maria-Luisa
authors.initials: ML
authors.lastname: Escobar
authors.forename: David
authors.initials: D
authors.lastname: de Ferranti
mesh_terms: D002681:China; D006078:Government Programs / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D018166:Health Care Reform / Q000191:economics* / Q000706:statistics & numerical data / Q000639:trends; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D008507:Medically Underserved Area; D009313:National Health Programs / Q000191:economics / Q000706:statistics & numerical data* / Q000639:trends; D012424:Rural Population; D014505:Urban Population